Optometry Coding: Stop 92081-92083 Denials in Their Tracks

Record visual fields interpretation and report the right way. Visual fields are a compliance hot spot. Optometrists should use the visual field interpretation and report (I&R) to record what their thinking process was at that moment by recording any changes noticed, how the field compares to other testing like OCT (92135, Scanning computerized ophthalmic diagnostic imaging, [...] Related articles:

  1. Ophthalmology Coding: GDX, VF, & Temp Plugs — How Many Modifiers?Question: A patient came in for a GDX and visual...
  2. Optometry Coding: Eye Exams, Cataract Surgery and Co-ManagementE/M or Eye Code? Choose Wisely With These Documentation Tips...
  3. Ophthalmology Coding: RT/LT or Modifier 50? Prevent Uni-Bi Reporting Errors With This Expert Insight Don’t...

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Pulmonology Coding Challenge: Why Are My 94664 Claims Getting Denied?

Before coding 94664, check off these items. Question: Under the direction of my pulmonologist I recently submitted 94664 for reimbursement for training time, but the bill was rejected? Can I challenge this? Answer: You can challenge training denials, provided your documentation supports the education’s reason. However, “not all payers will pay for 94664,” notes Gary N. Gross, [...] Related articles:

  1. Surgery Coding Challenge: Master Microsurgery Units With This AdviceCheck your EOB to make sure payers don’t apply a...
  2. 52214 Coding Challenge: Fulguration, Then TUIBNCQuestion: If my physician went to do a TUIBNC and...
  3. Radiology Coding Challenge: Why is Medicare Denying a 38792, 78195 ClaimTip: Discover true meaning of 38792 note Question: The physician...

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CMS Will Cover HIV Screening As Preventive Care Service

Bonus: Effective immediately! You’re probably accustomed to CMS taking away coverage for certain services, but in an early holiday gift to practices, CMS has actually added a preventive care service to its roster of covered screenings, effective immediately. CMS issued a final decision on Dec. 8 declaring that HIV testing will now be covered for Medicare beneficiaries [...] Related articles:

  1. Show Us the Money for Primary CareAlmost everyone agrees that federal and private insurers should reimburse...
  2. Colorectal Cancer Screening: A Medicare Coding & Billing FAQ Steer clear of G0121 denials with these tips. If...
  3. Good-Bye Fee-For-Service, Hello ‘Episodes of Care’It’s not like we’re going to go back to capitation...

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Facet Joint Injection Coding for 2010

Marvel Hammer’s Quick Start Guide to changes you’ll face in 2010. Tons of pain management coders gathered at the Orlando conference this week, and everyone was abuzz about the coding changes the painful reimbursement cuts their practices are going to get next year. Some big news: Effective January 1, 2010 radiological imaging will be required and bundled [...] Related articles:

  1. MAC Auditors Will Stick It To Facet Joint Injection Claims We hook you up with CMS instructions for when...
  2. Pain Management Coding Update: Facet Joint Injection CPT Changes for 2010Pain management, anesthesia, orthopedic, physiatry & neurology coders get ready...
  3. Audit Hot Spot: Facet Joint Injection ClaimsHere’s why the OIG wants to stick it to facet...

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CMS Will Offer New Modifier to Denote Admitting Physician on Claims

Pop the champagne cork & get ready for brand new inpatient coding rules. With the changes to consult coding in 2010, it will be more important than ever to report hospital visits properly. In the past, only the admitting physician reported initial hospital care codes (99221- 99223), and specialists who saw the patient separately often billed inpatient [...] Related articles:

  1. Answers To Your Hospital Admission, Subsequent Care Coding Questions Revenue Booster: Here’s when you can claim a consult...
  2. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  3. Proposed 2010 Physician Fee Schedule: A Closer Look21.5 percent cut looms for your services Last week, Coding...

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ED Coding Question: Observation or Other E/M Code?

Question: A 42-year-old patient reports to the ED early on Tuesday morning for evaluation of uncontrollable shaking in her extremities and severe pain in her neck. The EP admits the patient to observation at 7 a.m. and orders blood tests and a CT scan — however, the shaking continues to worsen. The EP consults with a [...] Related articles:

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  3. Observation Coding Do’s and Don’ts What’s the POS for an ED hallway? Answers to...

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Pain Management Coding: Endoscopic Lumbar Nerve Decompression

Hint: Think ‘unlisted procedure.’ Question: One of our physicians is looking into “endoscopic lumbar spinal nerve decompression.” One of the medical device representatives indicated he could bill it like the lateral extraforaminal approach for lumbar decompression, but I haven’t found much information. What’s your advice? Answer: Despite what you physician might have heard, your most appropriate choice [...] Related articles:

  1. Spinal Surgery Coding Challenge: Is Hemilaminectomy Bundled With Fusion?Question: Our orthopedic surgeon turned in a note that says,...
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  3. Anesthesia & Pain Management Denials: Sweep Them Away Now ‘Good Housekeeping’ tips that reduce denials. Tip 1: Beware...

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CMS at AMA Chicago: We’re Reducing Consult Request Requirement

CMS auditors will look for 1 less thing in consult documentation. With Medicare’s invalidation of consultation codes 99241-99255 in 2010, your ICD-9 codes better prove why two MDs are necessary on the same patient’s hospital care or the physician better specify why in his note. Separate ICD-9 codes will help substantiate the medical necessity for providing consultative [...] Related articles:

  1. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  2. Medicare Changes to 2010 CPT Inpatient Consultation Codes Prevent 99251-99245 denials in 2010 with this checklist. Multiple...
  3. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...

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Medicare Changes to 2010 CPT Inpatient Consultation Codes

Prevent 99251-99245 denials in 2010 with this checklist. Multiple physicians using the same hospital codes sounds like a recipe for denials, but that’s what Medicare is instructing physician inpatient consultants and care coordinators to do. Whether carriers will kick out these submissions as coordination of care or inpatient admit limiting admit edits is contractor specific, Charles [...] Related articles:

  1. Medicare 2010 CPT Consultation Code ChangesNew rules for consult coding straight from the AMA Meeting...
  2. Medicare’s Consult Rule Trickle Down Effect And what it means for pediatric practices. A report...
  3. Proposed 2010 MPFS: $26 More for ‘Welcome to Medicare’ ExamCMS welcomed health care providers to an July 9 open...

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Capture Separate CV Access Radiological Guidance

Don’t miss out on $20 per procedure when your surgeon performs central venous (CV) access device placements. If your physician uses fluoroscopic or ultrasonic guidance during the placement, you should separately report that service. We’ll show you how and tell you what modifier moves you need to make to prevent denials. Choose Between +76937 and +77001 If your [...] Related articles:

  1. Focus on Method to Ensure Proper Stereotactic Breast Biopsy CodingWatch out for the 77031 pitfall if the radiologist participates...
  2. Plantar Digital Nerve Coding Education: 64455 & 64632With these 4 tips, you’ll code clean claims every time....
  3. Cardiology Coding Question: Separate Reporting for 37204Question: Should I separately report right and left bronchial artery...

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Eye Surgery Coding Challenge: Denials for 15823 & 67904

Question: I started receiving denials for 15823 and 67904. To report this combo, should I use a modifier? Answer: If the ophthalmologist performs the blepharoplasty (bleph) with excessive weight (15823, Blepharoplasty, upper eyelid; with excessive skin weighting down lid) on one eye and the blepharoptosis (ptosis) repair (67904, Repair of blepharoptosis; [tarso] levator resection or advancement, [...] Related articles:

  1. Spinal Surgery Coding Challenge: Is Hemilaminectomy Bundled With Fusion?Question: Our orthopedic surgeon turned in a note that says,...
  2. Avoid This Blepharoplasty Coding Blunder  Don’t settle for denials for a functional surgery that...
  3. Spinal Surgery Coding Challenge: Tethered Cord Release & Dural Tag RemovalQuestion: My neurosurgeon released a tethered cord under the microscope,...

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Medical Office Billing: 7 Ways to Escape Computer Claim Casualties

Pay attention to EOBs and keep talking to your MAC. You could be losing money to a computer glitch and not know it, experts say. If you don’t nip a computer glitch in the bud, you may be plagued with improper denials and other claim holdups. Here are seven things you can do to seek out and [...] Related articles:

  1. Coders: Watch Out for Claim-Denying Computer Glitches Don’t wait for your MAC to alert you to...
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  3. Make Even Problem Payers Pay Up With These Tips From 2 ProsFollow this 3-step path and get results from every payer. At...

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Coders: Watch Out for Claim-Denying Computer Glitches

Don’t wait for your MAC to alert you to an error — be on the lookout for them. If you’ve been losing reimbursement to computer hiccups at your carrier, you’re not alone. Earlier this year, thousands of Medicare recipients in one state were wrongly told their benefits were being cut by $300 — but the state decided not to notify those affected with a letter. Instead, the state only told [...] Related articles:

  1. Medical Office Billing: 7 Ways to Escape Computer Claim CasualtiesPay attention to EOBs and keep talking to your MAC....
  2. Modifier 22 Moves for Ob-Gyn CodersThis U/S tactic will save you time — and add money...
  3. 15% More Pay Awaits Coders Who Can Max Out NPP BenefitCorrectly code NPP’s hospital services, or you’ll sell the practice...

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Toolkit: Chart Cardiology’s CCI 15.3 Changes At-a-Glance

Hang on to this handy table to avoid cath placement coding temptations. Correct Coding Initiative (CCI) 15.3 offered long lists of new edits, but we’ve boiled them down to the ones that affect cardiology coders and billers most. Cardiology Coders: A CCC™ Exam Prep Training Camp is coming to a city near you. Related articles:Take Heart, Cardiology Coders: CCI [...] Related articles:

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  3. Where Anesthesia Coders Go Wrong With CS Cath Placement   Your doc needs to do this to get...

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